Special anaesthesia: thyroid storm: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Special anaesthesia: thyroid storm

Sample item

A patient develops fever of 40 degrees C, heart rate of 160 per minute and agitation a few hours after thyroidectomy. Which drug controls the adrenergic features?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Intravenous esmolol

This picture suggests thyroid storm. Beta blockade with esmolol or propranolol controls tachycardia, and propranolol also reduces peripheral T4 to T3 conversion. Treatment also includes a thionamide, iodine given after it, steroids, cooling and fluids; aspirin is avoided because it displaces thyroid hormone from binding proteins.

Option by option

  • A. Aspirin for the fever

    Aspirin raises free thyroid hormone by displacing it from protein binding.

  • B. Intravenous esmolol (correct)

    Correct. A beta blocker controls the adrenergic effects of thyroid hormone excess.

  • C. Neostigmine

    Neostigmine causes bradycardia and secretions but does not treat thyroid storm.

  • D. Dobutamine

    Dobutamine would worsen tachycardia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, Intravenous esmolol. This picture suggests thyroid storm.

Why is "Aspirin for the fever" not the answer?

Aspirin raises free thyroid hormone by displacing it from protein binding.

Why is "Neostigmine" not the answer?

Neostigmine causes bradycardia and secretions but does not treat thyroid storm.

Why is "Dobutamine" not the answer?

Dobutamine would worsen tachycardia.

What concept does this question test?

It tests Special anaesthesia: thyroid storm in Anaesthesia. Beta blockade with esmolol or propranolol controls tachycardia, and propranolol also reduces peripheral T4 to T3 conversion. Treatment also includes a thionamide, iodine given after it, steroids, cooling and fluids; aspirin is avoided because it displaces thyroid hormone from binding proteins.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Special anaesthesia: thyroid storm?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.